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Toronto, AL M5N 2M7
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christian@orthogate.com






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I read a true story about a woman who lost the use of her arms after surgery. I myself am a paraplegic with no sensation or function below the belt. How could she lose sensation and movement of the arms but not the legs? This doesn't make any sense to me.

You may be describing a problem called man-in-the-barrel syndrome (MIB). Man-in-the-barrel syndrome (MIB) presents as complete loss of movement in the arms. This symptom is referred to as brachial diplegia. The affected individual can feel pain but cannot move in response to it. There are several possible reasons why someone might develop this problem. It could occur as a result of a loss of blood supply to the region of the brain that controls the arms. Ischemia (blood loss) to the area between the anterior and middle cerebral arteries supplying the temporoparietal region of the brain is the key area affected. The legs aren't affected because the corticospinal tracts (spinal pathway to and from the brain) that controls the legs isn't affected. Experts in brain anatomy say that there are two separate corticospinal tracts: one for the arms and one for the legs. Both can be affected at the same time, but it's more common for just one area to be affected. The underlying event leading to this complication could be the sudden loss of blood pressure. Rapid fall in blood pressure can result in brain damage. A previous history of high blood pressure can contribute to the problem. If it happens soon after a surgical procedure, there may be other reasons why this occurs as a complication of the procedure. Other cases of brachial diplegia have been linked with brain cancer, brain hemorrhage, traumatic brain injury, and cardiac arrest. Complications from any surgery but especially spine and heart surgery can also cause ischemia and damage to this area of the brain. In the case of a spinal cord injury, there isn't selected brain damage. Instead, the spinal cord (after it has left the brain) has been pressed, cut, or damaged in some way. All sensation and motor control below the damaged area is affected. With today's new treatments, complete paralysis below the lesion is no longer the rule. Many people experience sparing of function because swelling is kept to a minimum after injury.

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